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Association Between Symptoms of Depression and Contraceptive Method Choices Among Low-Income Women at Urban Reproductive Health Centers

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Abstract

Among adult women of reproductive age, research has focused on depression symptoms after unintended pregnancy, or associated with hormonal contraceptive method use, with little focus on depression as a predictor of unintended pregnancy. This study was conducted to identify mental and behavioral health characteristics associated with use of less effective contraceptive methods. Choosing a less effective method of contraception places sexually active women who are not seeking pregnancy at increased risk of unintended pregnancy. Analysis was conducted using administrative data from family planning visits of 2,476 predominantly Latina and black women who received standardized behavioral and mental health screening as part of clinical care at eight reproductive health centers in New York City serving low-income women. Sociodemographic characteristics, method choice, and behavioral and mental health characteristics were compared between patients who screened positive for depression (using the PHQ-9) and those who did not. The primary outcome measure, contraceptive method choice, was dichotomized into two groups: more effective method or less effective method. In a multivariate logistic regression model adjusting for all behavioral health characteristics (binge drinking, illicit drug use, smoking, anxiety, and childhood or adult physical or sexual abuse) and birthplace, women screening positive for depression had significantly lower odds of choosing a more effective method of contraception (adjusted OR = 0.56, 95% CI: 0.36–0.87). These findings suggest that screening positive for depression may have an effect on contraceptive choice. Contraceptive counseling strategies should be individually tailored to promote decision-making and appropriate contraceptive choice, particularly among women with depression.

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Acknowledgments

Supported in part by project D63MC00050 from the Maternal and Child Health Bureau (Social Security Act, Title V; 42 U.S·C. 701), Health Resources and Services Administration, Department of Health and Human Services and The New York Community Trust. Thanks to Kathryn Miller, Erica Goodwin and Hong Gao of MIC-Women’s Health Services.

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  1. Public Health Solutions, 220 Church Street, 5th Floor, New York, NY, 10013, USA

    Samantha Garbers, Nereida Correa, Natalie Tobier, Sarah Blust & Mary Ann Chiasson

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  1. Samantha Garbers
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  2. Nereida Correa
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Correspondence to Samantha Garbers.

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Garbers, S., Correa, N., Tobier, N. et al. Association Between Symptoms of Depression and Contraceptive Method Choices Among Low-Income Women at Urban Reproductive Health Centers. Matern Child Health J 14, 102–109 (2010). https://doi.org/10.1007/s10995-008-0437-y

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  • DOI: https://doi.org/10.1007/s10995-008-0437-y

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